Contact

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Current Address *

Date of Birth

Marital Status *

Employment & Income

Are You Currently Employed? *

Employer Name

Monthly Household Income *

Income Source(s)

Housing Preferences

Are You Looking to Rent or Purchase? *

🏠 Rent

🔔 Purchase

✨ Open to Either

Bedrooms Needed *

Bathrooms Needed *

Preferred Move-In

Downsizing or Upsizing? *

Downsizing

Upsizing

Same Size

First Home

Total Number of Occupants *

Number of Children (under 18)

Voucher & Background

Do You Currently Have a Housing Voucher? *

Yes - Section 8 / HCV

Yes - VASH (Veteran)

Yes - Other Program

No Voucher

Applied / Pending

Are You a Veteran? *

Yes, I am a veteran

Active duty

Veteran family member

Have You Ever Been Evicted From a Previous Residence? *

Yes

If yes, please provide details in the additional comments section below.

Do You Have Any Pets?

Do You Have Reliable Transportation?

Do You Have Any Special Accessibility Needs?

Additional Information

How Did You Hear About Haiku Homes?

Additional Comments or Questions

✓

Application Submitted!

Thank you for applying with Haiku Homes. We've received your application and will review it within 2-3 business days. You'll receive a confirmation email shortly.

[email protected]

Location

Philadelphia & Lehigh Valley, PA

Focus Areas